What is Postnatal Depression and the Symptoms
Postnatal depression is when a person experiences a prolonged period of depressive symptoms shortly after childbirth. Here we talk about the symptoms of post-natal depression and how to overcome it.
the difference between the terms baby blues and postnatal depression
Baby blues is where a person has a low mood, irritability and weepiness in the first couple of weeks after the birth of their child but this is usually short lived.
Post natal depression is a condition where a person experiences a prolonged period of depressive symptoms shortly after childbirth.
The baby blues are not the same as PND whereas the baby blues usually lift within the first week or so, PND is much more prolonged and the symptoms are usually more distressing and disabling.
some of the common symptoms of postnatal depression
PND affects how a person feels, thinks and behaves. The symptoms can include:
- Feeling low, particularly in the mornings.
- Feeling irritable and short-tempered.
- Having negative and pessimistic thoughts such as believing that they are a failure because they find it difficult to cope or feeling guilty for not enjoying being a mother).
- Tearfulness
- Difficulty in sleeping or sleeping too much.
- Obsessional thoughts ( unwanted and upsetting thought or images when frequently concern the baby).
- Thoughts about self-harm or suicide.
six possible risk factors
Risk factors before the baby is born:
- Difficulties in conceiving – fertility problems
- Past history of depression
- A history of mental illness in the family, particularly PND
- Being a single parent ( without a support network)
- Financial difficulties
- Having a child when very young ( under the age of 16)
- An unexpected or unwanted pregnancy
- Excessive anxiety/stress during last three months of pregnancy
- A difficult labour
Risk factors after the baby is born:
- Premature birth
- Physical illness of the mother
- Physical illness or disability of the baby
- Social isolation
- Lack of support from the person’s partner
- Returning to work at a lower level of seniority
three possible causes
Hormonal changes – The rapid hormonal changes that accompany pregnancy and delivery may trigger depression.
After childbirth, women experience a big drop in oestrogen and progesterone hormone levels. Thyroid levels can also drop, which leads to fatigue and depression.
Physical and emotional factors – Women may still be coping with physical pain from the pregnancy and delivery. Some women have difficulties losing the baby weight and can lead to loss of self-esteem and don’t feel sexually attractive.
The stress of caring for a newborn can also be stressful as new mums are sleep deprived and have difficulty in breast feeding. This can lead to being overwhelmed and being anxious.
Lack of support – in the past women came from large families and lived in a very close proximity to each other. New mothers could expect support from numerous members of the family all of which tended to live in the same community.
Nowadays families have become smaller and are spread out geographically so new mothers can feel they are left alone in the world to with the demands of motherhood.
some of the ways postnatal depression affects the mother, including bonding with her baby
Depression and anxiety often co-exist in PND. Some mothers feel constantly restless and on edge. Some have feelings of panic or actual panic attacks and can lead to some mothers not leaving the house.
Others are unable to relax at home and feel that they will go mad if they stay in the house. As a result some find themselves spending much of their time wondering around parks and shopping centres without any real purpose and avoiding going home.
Some mothers with PND and who are anxious experience obsessional and frightening thoughts for eg. develop irrational beliefs about the health and safety of their baby.
Research shows that depressed mothers tend to interact less with their babies. For, e.g. they are less likely to breastfeed, play with and read to their children.
They are also less likely to pick up on and respond to their baby’s cues for warmth and attention, affecting the bonding process.
Some depressed mothers can be loving and attentive at times but other times they may react negatively or they may not respond at all.
how postnatal depression can affect friends and family
Some family or friends may become extremely distressed seeing the mother trying to cope with the baby and the symptoms of the depression.
Family and friends that are asked to help can become exhausted as they take on extra roles and chores on behalf of the mother. Partners may have to take extra time off work, and this can cause financial stress on the family.
Relationships with and between other siblings can become fraught if they themselves feel neglected.
BIRTH PREPARATIONS
Formulate a birth plan
This is a document that records what that parent wishes in terms of location and type of delivery that they want.
Although things may turn out differently when the time arrives, it gives the mother security of knowing plans are in place, and her wishes have been recorded.
Choose an appropriate birth partner
This is someone that will support the woman throughout the pregnancy and be there at the birth for practical and emotional support.
Keep fit and healthy during pregnancy
Expectant mothers are advised to eat well and maintain a sensible exercise amount. This affects the physical well-being of the baby and the well-being of the baby.
three help measures
Finding someone to talk about your feelings
Do not keep your feelings to yourself. Share them with friends or family. Let your loved ones know what you need and how you like to be supported.
Don’t be afraid to ask for help
Allow people to help you with childcare, housework and errands so you can get some much need rest.
Learn to sleep when the baby sleeps
Getting an adequate amount of sleep is often difficult with a new child, so it is important to take the opportunity for a nap whilst the baby is sleeping. If you are awake at night, try to relax reading or listen to music and not worry about sleeping.
three possible treatments for postnatal depression
Numerous talking therapies have been found effective in helping women with PND. Some examples of talking therapies used to treat PND are:
Interpersonal therapy – focuses on interpersonal relationships and issues and is believed to particularly effective.
Cognitive behaviour therapy – this focuses on coping strategies and challenging unhelpful thoughts and beliefs.
General counselling – this is where the person can talk about the way they are feeling to a trained counsellor/therapist and how they can overcome their symptoms.
If women’s symptoms are more serious, medication is usually offered such as:
Antidepressants: for women with moderate to severe PND certain types of antidepressants can be effective.
If the mother is breastfeeding it is important the GP is made aware so they are offered alternative medication.
Hormone therapy – oestrogen replacement therapy can help PND. The replacement can counteract the rapid drop in oestrogen that accompanies child birth.
examples of local support
The persons health visitor, midwife and GP are the key source of support.
The health visitor can provide support on breastfeeding and health issues and they can put them in contact with local support groups.
Midwives can offer emotional support aswell as the health visitor.
If health issues are more serious then her GP can prescribe drug and/or talking therapies.
Mother and baby groups are a emotional support and companionship for new mothers. They also discuss parenting skills and coping strategies.
the special features and characteristics of puerperal psychosis
This type of depression is characterised by loss of contact with reality. It develops suddenly, usually within the first two weeks after delivery, and sometimes within the first forty-eight hours.
Symptoms include hallucinations, delusions, extreme agitation and anxiety, confusion and disorientation, rapid mood swings, bizarre behaviour, inability or refusal to eat or sleep, suicidal thoughts or actions, thoughts of harming or killing the baby.
Women with bipolar disorder are at an increased risk of developing puerperal psychosis. Their symptoms are very similar.
It is also more likely to occur in women who have experienced schizophrenia in the past or if a family member has had it.
There is also an increased risk of infanticide or suicide. This is because they are experiencing a break from reality.
Delusion and hallucinations are genuine and meaningful and are often religious and sometimes involve violent commands.
resources and treatments a person with puerperal psychosis would require
Hospitalisation is usually required to keep the mother and baby safe. She will remain there until fully assessed.
Medication maybe be prescribed depending on her symptoms such as:
- Lithium to control her mood.
- Antidepressants to lift the woman’s mood.
- Antipsychotics to help control the delusions and hallucinations.
- Electro-convulsive therapy may be recommended for some severely depressed where the medication has not been effective.
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